Concept

Obstructed defecation

Summary
Obstructed defecation syndrome (abbreviated as ODS, with many synonymous terms) is a major cause of functional constipation (primary constipation), of which it is considered a subtype. It is characterized by difficult and/or incomplete emptying of the rectum with or without an actual reduction in the number of bowel movements per week. Normal definitions of functional constipation include infrequent bowel movements and hard stools. In contrast, ODS may occur with frequent bowel movements and even with soft stools, and the colonic transit time may be normal (unlike slow transit constipation), but delayed in the rectum and sigmoid colon. Constipation is usually divided into two groups: primary and secondary. Primary constipation is caused by disrupted regulation of neuromuscular function of in the colon and the rectum, and also disruption of brain–gut neuroenteric function. Secondary constipation is caused by many other different factors such as diet, drugs, behavioral, endocrine, metabolic, neurological, and other disorders. There are main subtypes of primary constipation which are recognized, although overlap exists (see: Co-existence of different constipation subtypes): dyssynergic defecation, slow transit constipation (colonic dysmotility) and irritable bowel syndrome with constipation. Obstructed defecation is one of the causes of chronic constipation. ODS is a loose term, consisting of a constellation of possible symptoms, caused by multiple, complex and poorly understood disorders which may include both functional and organic disorders. The topic of defecation disorders is very complicated, and there is a lot of confusion regarding terminology and classification in published literature. Occasionally some sources inappropriately treat ODS as a synonym of anismus. Although anismus is a major cause of ODS, there are other possible causes. Other authors use the term ODS to refer to defecatory dysfunction in the absence of any pathological findings (that is, a purely functional disorder).
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